Document Type
Article
Abstract
Background
Chagas disease is a chronic, insidious parasitic infection (Trypanosoma cruzi) that slowly develops to irreversible organomegaly over several decades. The disease is traditionally acquired in endemic Latin American countries during childhood; < 1% of foreign-born adult residents in the United States have been diagnosed or treated with this potentially fatal disease. Low physician knowledge is a primary factor leading to misdiagnosis.
Methods
Starting in April 2022, a 4-part T cruzi clinical education intervention began, which included (i) 2 grand rounds presentations to >100 internal medicine providers; (ii) implementation of a “clinical Chagas champions program” incorporating 14 key clinical staff at varying departments and administrative levels educated on their specific role related to T cruzi screening, diagnosis confirmation, clinical management, and medical billing; (iii) connecting clinicians with external, experienced providers to provide guidance during the medically challenging treatment process; and (iv) T cruzi patient screening at Prisma Health hospitals, family medicine clinics, or affiliated free health clinics. The program's long-term impact was evaluated using a panel Poisson time series statistical model of ordered tests pre- and post-intervention.
Results
For the healthcare system screening initiative, 71 participants were enrolled from across Prisma Health's 21-county region, with a 2.9% Chagas disease seroprevalence detected. Time series analysis of T cruzi testing orders within the healthcare system demonstrated a statistically significant increase in ordered tests across the 30 months post-intervention compared to the 51 months prior.
Conclusions
This intervention substantiates the need to pair academic-health partnerships and clinical awareness campaigns to sustainably support long-term T cruzi screening in nontraditional areas.
Digital Object Identifier (DOI)
Publication Info
Published in Open Forum Infectious Diseases, Volume 12, Issue 8, 2025.
Rights
© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
APA Citation
Lynn, M. K., Boehme, H. M., Hall, J., Kent, P., Litwin, A. H., Pham, Q. H., Nolan, M. S., Rodriguez, C. M., Parker, M., Waltz, H., Zellars, K., Meyer, M. M., & Whittle, K. (2025). An Evidence-Based Intervention to Increase Trypanosoma cruzi, a Neglected Parasitic Infection, Diagnosis in Rural and Moderate-Size-City US Clinics. Open Forum Infectious Diseases, 12(8). https://doi.org/10.1093/ofid/ofaf467